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General NPI Number Information
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NPI Number | 1720329113
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Entity Type | Organization
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Legal Business Name | CAROCIBA INC
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 04/25/2013
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Provider Practice Location Address
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Address Line | 710 S 13TH ST STE 900
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City | NORFOLK
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State | NE
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Zip | 68701-5792
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Country | US
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Telephone | 404-324-0515
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Fax | 402-844-4114
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Provider Business Mailing Address
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Address Line | 710 S 13TH ST STE 900
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City | NORFOLK
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State | NE
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Zip | 68701-5792
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Country | US
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Telephone | 404-324-0515
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Fax | 402-844-4114
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Authorized Official
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Title or Position | OWNER
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Name | TAYO OBATUSIN
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Credential |
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Telephone | 404-324-0515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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